Jacob Wolkow, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11823 Issued in TN

Practice address

264 S Peters Rd
Knoxville, TN 37923-5203

Phone

(865) 539-1776

NPI assigned

Jun 16, 2021

Last updated

Jun 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Malone & Costa, PLLC

  • General Practice Dentistry
  • Knoxville, TN
  • NPI 1174183990
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1720656580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 OKEMA LN",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377743158",
            "telephone_number": "205-834-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 S PETERS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235203",
            "telephone_number": "865-539-1776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8410 Datapoint Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293220",
            "country_code": "US",
            "telephone_number": "210-949-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLKOW",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekha Lynn Wolfenbarger, CNA
• Madeleine Wolfenberger
• William R Wolff, CRNA
• Savannah Jane Wolfgram
• Victoria L. Wolfgramm, M.D.
• Myriah Ann-Marie Wolosik
• Amanda Womac-Boling, MSN, RN
• Holli Marie Womack, NP
• James D Womack Jr., PA-C
• Kristen Elizabeth Womack, B.A.

• General Practice Dentistry in Knoxville, TN
• Providers in Knoxville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.